title: St. Jude Medical Trifecta™ aortic valve perioperative performance in 200 patients.
abstract: OBJECTIVE
  The St. Jude Medical Trifecta aortic bioprosthesis (St. Jude Medical, Inc., St. Paul, MN, USA) is a new stented pericardial tissue heart valve. The aim of the study was to evaluate the clinical and haemodynamic performance of the Trifecta bioprosthesis in the early postoperative period.
  
  
  METHODS
  From July 2010 to September 2012, a total of 200 consecutive patients underwent aortic valve replacement with the Trifecta valve in our institution. All intraoperative and postoperative data were prospectively collected. Mean EuroSCORE II was 3.98%. Echocardiography was performed at discharge in all patients.
  
  
  RESULTS
  The mean age was 71.2 ± 7.7 (range 39-89 years). Extubation in the operating theatre was successfully performed in 96% of patients. Mean hospital stay was 8.5 days. The prosthesis sizes were 19 mm (n = 33), 21 mm (n = 81), 23 mm (n = 59), 25 mm (n = 23) and 27 mm (n = 4). Mean systolic pressure gradients ranged from 9.4 mmHg (size 19 valve) to 4.8 mmHg (size 27 valve). Mean effective orifice area (EOA) ranged from 1.61 cm(2) (size 19 valve) to 2.5 cm(2) (size 27 valve). Severe mismatch (<0.65 cm(2)/m(2)) did not occur in any patient. Of note, 99.5% of patients had mild or no aortic insufficiency at discharge. The early (30-day) mortality was 2.5% (n = 5).
  
  
  CONCLUSIONS
  The Trifecta valve offers good clinical results and excellent haemodynamic performance. Special care must be taken to avoid oversizing, which can lead to difficulty in implantation and can produce gradient increases due to an excess of prosthetic leaflet tissue.
authors.affiliation: Department of Cardiac Surgery, Hospiten Rambla, Santa Cruz de Tenerife, Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Permanyer
authors.forename: Arnaldo-Javier
authors.initials: AJ
authors.lastname: Estigarribia
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ysasi
authors.forename: Enrique
authors.initials: E
authors.lastname: Herrero
authors.forename: Omar
authors.initials: O
authors.lastname: Semper
authors.forename: Rafael
authors.initials: R
authors.lastname: Llorens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D002114:Calcinosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aortic valve; Mean effective orifice area; Mean systolic pressure gradients; Trifecta bioprosthesis